Tool for Financial Risk of Cancer Patients – Financial Toxicity

A tool to assess ‘financial toxicity’ for cancer patients namely the expense, anxiety and stress of illness related costs has been developed by University of Chicago Medical Center cancer specialists. Many cancer patients face exorbitant and unpredictable treatment costs often at a time when they’re less able to work, the researchers point out.

“Few physicians discuss this increasingly significant side effect with their patients,” study author Dr. Jonas de Souza, a head-and-neck cancer specialist said in a university news release. “Physicians aren’t trained to do this. It makes them, as well as patients feel uncomfortable. We aren’t good at it.”

According to de Souza, “a thoughtful, concise tool that could help predict a patient’s risk for financial toxicity might open the lines of communication and gives us a way to launch that discussion.”

Financial pain may extend beyond treatment. A recent study from the Centers for Disease Control and Prevention found that 30 percent of cancer survivors are not able to return to work or have decreased ability to work. Annual medical expenditures increase by more than $4,000 for males who have had cancer and by nearly $3,300 for females.

A COST questionnaire was developed with a literature review and a series of extensive interviews. De Souza and colleagues spoke with 20 patients and six cancer professionals as well as nurses and social workers. That produced a list of 147 questions. The researchers pared the list down to 58 questions. Then they asked 35 patients to help them decide which of the remaining questions were the most important. The patients narrowed the list down to 30.

The researchers are now conducting a larger study to validate these findings and correlate the newly developed scale with quality of life and anxiety in cancer patients.

“We need to assess outcomes that are important for patients,” de Souza said. The cost burden cancer patients experience is definitely one. Measuring this toxicity is the first step towards addressing this important issue. “At the end,” he added, “this is another important piece of information in the shared-decision-making process.”